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4D-150 in Patients With Diabetic Macular Edema

Primary Purpose

Diabetic Macular Edema, Diabetic Retinopathy

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
4D-150 IVT
Aflibercept IVT
Sponsored by
4D Molecular Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Macular Edema focused on measuring Retinal gene therapy, Intravitreal gene therapy, DME, SPECTRA

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: ≥18 years of age Type I or Type II diabetes mellitus with macular thickening secondary to DME involving the center of the fovea Demonstrate clinical response to on-study aflibercept injection in the study eye. Decreased visual acuity attributable primarily to DME BCVA in the study eye between 25 and 83 ETDRS letters, inclusive (~20/320 and 20/25, respectively) at Screening Study eye amenable to IVT injection Sufficient clear ocular media, pupil dilation and fixation in the study eye to permit adequate imaging; ability to perform tests of visual and retinal function and structure; and ability to comply with other protocol-specified procedures Provide written informed consent Exclusion Criteria: Macular edema in the study eye considered to be secondary to a cause other than DME Systemic anti-VEGF treatment (e.g. sunitinib, bevacizumab, pazopanib) within 6 months, or anticipated need for systemic anti-VEGF therapy during study participation Systemic corticosteroids (oral, intravenous, intramuscular, intra-articular) or other immunosuppressive medications within 3 months Received an investigational drug, agent, device, or therapy (ocular or non-ocular) in the 6 months or at least 5 half-lives (whichever is longer) prior to Screening Prior gene therapy (ocular or non-ocular) and/or ocular stem cell therapy in either eye Any concurrent ocular condition in the study eye that is likely to require surgical intervention (e.g. cataract surgery) during the 2 year (104 week) study duration Note: Other inclusion/exclusion criteria apply.

Sites / Locations

  • National Ophthalmic Research InstituteRecruiting
  • Cumberland Valley Retina ConsultantsRecruiting
  • Verum Research, LLCRecruiting
  • Erie Retina ResearchRecruiting
  • Austin Clinical ResearchRecruiting
  • Piedmont Eye CenterRecruiting
  • Emanuelli Research and Development CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Active Comparator

Experimental

Experimental

Active Comparator

Arm Label

4D-150 Part 1 Dose Confirmation Dose Level 1

4D-150 Part 1 Dose Confirmation Dose Level 2

4D-150 Part 1 Dose Confirmation Control

4D-150 Part 2 Dose Expansion Dose Level 1

4D-150 Part 2 Dose Expansion Dose Level 2

4D-150 Part 2 Dose Expansion Control

Arm Description

4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.

4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.

Aflibercept will be administered PRN.

4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.

4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.

Aflibercept at a fixed regimen will be administered.

Outcomes

Primary Outcome Measures

Annualized number of aflibercept injections in the study eye

Secondary Outcome Measures

Mean cumulative number of aflibercept injections over time
Change from baseline in BCVA as assessed using the ETDRS Visual Acuity Chart
Change from baseline in CST measured by spectral domain optical coherence tomography (SD-OCT)
Percentage of subjects with a ≥2 and ≥3-Step Diabetic Retinopathy Severity (DRS) improvement from baseline on the ETDRS-DRSS

Full Information

First Posted
June 26, 2023
Last Updated
August 29, 2023
Sponsor
4D Molecular Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT05930561
Brief Title
4D-150 in Patients With Diabetic Macular Edema
Official Title
A Phase 2 Randomized, Active-Controlled, Double-masked Trial of Intravitreal 4D-150 Gene Therapy in Adults With Diabetic Macular Edema (SPECTRA)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 9, 2023 (Actual)
Primary Completion Date
February 29, 2028 (Anticipated)
Study Completion Date
July 1, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
4D Molecular Therapeutics

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Phase 2 randomized, active-controlled, double-masked, dose-ranging trial in adults with Diabetic Macular Edema (DME).
Detailed Description
This Phase 2 trial is a prospective, multicenter, randomized, active-controlled, double-masked dose-ranging trial to evaluate the safety and efficacy of 4D-150 in adults with DME. The trial will be conducted in two parts: Dose Confirmation and Dose Expansion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Macular Edema, Diabetic Retinopathy
Keywords
Retinal gene therapy, Intravitreal gene therapy, DME, SPECTRA

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
In Dose Confirmation, subjects (n=18) will be randomized to receive one of two dose levels of 4D-150 (n=6 per dose level) or aflibercept control (n=6). In Dose Expansion, subjects (n=54) will be randomized to receive one of two dose levels of 4D-150 (n=18 per dose level) based on results from Dose Confirmation, or aflibercept control (n=18).
Masking
ParticipantOutcomes Assessor
Masking Description
Participants and outcomes assessors will be masked to treatment arm for the duration of the trial.
Allocation
Randomized
Enrollment
72 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
4D-150 Part 1 Dose Confirmation Dose Level 1
Arm Type
Experimental
Arm Description
4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.
Arm Title
4D-150 Part 1 Dose Confirmation Dose Level 2
Arm Type
Experimental
Arm Description
4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.
Arm Title
4D-150 Part 1 Dose Confirmation Control
Arm Type
Active Comparator
Arm Description
Aflibercept will be administered PRN.
Arm Title
4D-150 Part 2 Dose Expansion Dose Level 1
Arm Type
Experimental
Arm Description
4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.
Arm Title
4D-150 Part 2 Dose Expansion Dose Level 2
Arm Type
Experimental
Arm Description
4D-150 will be administered at the assigned dose level as a single dose IVT injection on Day 1.
Arm Title
4D-150 Part 2 Dose Expansion Control
Arm Type
Active Comparator
Arm Description
Aflibercept at a fixed regimen will be administered.
Intervention Type
Biological
Intervention Name(s)
4D-150 IVT
Intervention Description
4D-150: AAV-based gene therapy comprised of miRNA targeting VEGF-C and codon-optimized sequence encoding aflibercept.
Intervention Type
Biological
Intervention Name(s)
Aflibercept IVT
Other Intervention Name(s)
Eylea
Intervention Description
Commercially available Active Comparator
Primary Outcome Measure Information:
Title
Annualized number of aflibercept injections in the study eye
Time Frame
52 weeks
Secondary Outcome Measure Information:
Title
Mean cumulative number of aflibercept injections over time
Time Frame
52 weeks
Title
Change from baseline in BCVA as assessed using the ETDRS Visual Acuity Chart
Time Frame
104 weeks
Title
Change from baseline in CST measured by spectral domain optical coherence tomography (SD-OCT)
Time Frame
104 weeks
Title
Percentage of subjects with a ≥2 and ≥3-Step Diabetic Retinopathy Severity (DRS) improvement from baseline on the ETDRS-DRSS
Time Frame
104 weeks
Other Pre-specified Outcome Measures:
Title
Incidence and severity of treatment-emergent adverse events and serious adverse events, including clinically significant changes in safety parameters
Time Frame
104 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥18 years of age Type I or Type II diabetes mellitus with macular thickening secondary to DME involving the center of the fovea Demonstrate clinical response to on-study aflibercept injection in the study eye. Decreased visual acuity attributable primarily to DME BCVA in the study eye between 25 and 83 ETDRS letters, inclusive (~20/320 and 20/25, respectively) at Screening Study eye amenable to IVT injection Sufficient clear ocular media, pupil dilation and fixation in the study eye to permit adequate imaging; ability to perform tests of visual and retinal function and structure; and ability to comply with other protocol-specified procedures Provide written informed consent Exclusion Criteria: Macular edema in the study eye considered to be secondary to a cause other than DME Systemic anti-VEGF treatment (e.g. sunitinib, bevacizumab, pazopanib) within 6 months, or anticipated need for systemic anti-VEGF therapy during study participation Systemic corticosteroids (oral, intravenous, intramuscular, intra-articular) or other immunosuppressive medications within 3 months Received an investigational drug, agent, device, or therapy (ocular or non-ocular) in the 6 months or at least 5 half-lives (whichever is longer) prior to Screening Prior gene therapy (ocular or non-ocular) and/or ocular stem cell therapy in either eye Any concurrent ocular condition in the study eye that is likely to require surgical intervention (e.g. cataract surgery) during the 2 year (104 week) study duration Note: Other inclusion/exclusion criteria apply.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
4DMT Patient Advocacy
Phone
(888) 748-8881
Email
clinicaltrials@4DMT.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Schonmei Lee, MD
Organizational Affiliation
4D Molecular Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
National Ophthalmic Research Institute
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33912
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lee Toleman
Email
leet@eye.md
First Name & Middle Initial & Last Name & Degree
Katrina Mears, MD
Facility Name
Cumberland Valley Retina Consultants
City
Hagerstown
State/Province
Maryland
ZIP/Postal Code
21740
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Erica Buls
Email
ericab@retinacare.net
First Name & Middle Initial & Last Name & Degree
Allen Hu, MD
Facility Name
Verum Research, LLC
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ryan Lieben
Email
rlebien@verumresearch.com
First Name & Middle Initial & Last Name & Degree
Albert Edwards, MD
Facility Name
Erie Retina Research
City
Erie
State/Province
Pennsylvania
ZIP/Postal Code
16507
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Beth Hess
Email
ehess@erieretinaresearch.com
First Name & Middle Initial & Last Name & Degree
David Almeida, MD
Facility Name
Austin Clinical Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78750
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ivana Gunderson
Email
igunderson@austinclinicalresearch.com
First Name & Middle Initial & Last Name & Degree
Brian Berger, MD
Facility Name
Piedmont Eye Center
City
Lynchburg
State/Province
Virginia
ZIP/Postal Code
24502
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Susan Shelton
Email
sshelton@piedmonteye.com
First Name & Middle Initial & Last Name & Degree
Golnaz Javey, MD
Facility Name
Emanuelli Research and Development Center
City
Arecibo
ZIP/Postal Code
X00612
Country
Puerto Rico
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diane Perez
Email
dperez@erdpr.com
First Name & Middle Initial & Last Name & Degree
Andres Emanuelli, MD

12. IPD Sharing Statement

Learn more about this trial

4D-150 in Patients With Diabetic Macular Edema

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